Comparison of sirolimus-eluting stent and paclitaxel-eluting stent for long-term cardiac adverse events in diabetic patients: the Korean Multicenter Angioplasty Team (KOMATE) Registry.
BACKGROUND
There is some controversy on long-term cardiac outcomes between sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in diabetes mellitus (DM). We compared cardiac adverse events after SES and PES implantation in patients with DM over a period of 3 year.


METHODS
A total of 634 patients with DM treated with SES (n = 428) or PES (n = 206) were consecutively enrolled in the KOMATE registry from 2003 to 2004. We assessed major adverse cardiac events (MACEs, cardiovascular death, nonfatal myocardial infarction, ischemia driven target vessel revascularization) and stent thrombosis (ST) according to the definitions set by the Academic Research Consortium.


RESULTS
Propensity score (PS) analysis was performed to adjust different baseline characteristics. The mean follow-up duration was 38 +/- 8 month (at least 36 month and up to 53 month). The 3-year MACE rate did not show a significant difference between the two groups [52 (12.1%) in SES vs. 29 (14.1%) in PES, P = 0.496]. The definite and probable ST at 3 year were similar in both SES and PES [12 (2.8%) in SES vs. 7 (3.4%) in PES, P = 0.681]. There were no differences in hazard ratio for MACE and ST between two stents [MACE, crude: 0.844 (0.536-1.330) and adjusted for PS: 0.858 (0.530-1.389); ST, crude: 0.820 (0.323-2.083) and adjusted for PS: 0.960 (0.357-2.587)].


CONCLUSIONS
The present study demonstrated that long-tem cardiac outcomes including ST were not significantly different between SES and PES in patients with DM.
Kim
Jung-Sun
JS
Yonsei Cardiovascular Center, Seoul, Republic of Korea.
Lee
Byoung Ho
BH
Ko
Young-Guk
YG
Choi
Donghoon
D
Jang
Yangsoo
Y
Min
Pil-Ki
PK
Yoon
Young-Won
YW
Hong
Bum Kee
BK
Kwon
Hyuck Moon
HM
Ahn
Min-Soo
MS
Lee
Seung-Hwan
SH
Yoon
Jung Han
JH
Lee
Byoung Kwon
BK
Kim
Byung Ok
BO
Kim
Byeong-Kuk
BK
Oh
Sung Jin
SJ
Jeon
Dong Woon
DW
Yang
Joo Young
JY
Cho
Jung Rae
JR
Jung
Jae-Hun
JH
Ryu
Seung-Ki
SK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D012042:Registries; D018570:Risk Assessment; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D017239:Paclitaxel; D020123:Sirolimus